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Pennsylvania workers' compensation insurance: Your guide to requirements and getting a policy
If you’re a Pennsylvania employer looking to protect both your business and your team, you’re in the right place. At Beyond, we provide the essential information you need to understand how workers’ compensation works and how to stay compliant.
Under the Pennsylvania Workers’ Compensation Act, nearly all employers in the state must provide workers’ compensation coverage if they employ one or more individuals—this includes full-time, part-time, seasonal employees, and even family members.
However, some employers may be exempt from providing coverage for certain categories of workers. These exemptions include:
Employees covered under other workers’ compensation laws (e.g., federal employees, railroad workers)
Domestic workers (coverage optional)
Agricultural laborers working fewer than 30 days or earning less than $1,200 per calendar year from the same employer
Workers with religious exemptions
Executive officers of certain corporations who opt out and are approved for exemption
Certain licensed real estate salespersons and brokers
Employers must file exemption applications with the Pennsylvania Department of Labor and Industry’s Bureau of Workers’ Compensation (BWC), which administers the workers’ compensation program.
Independent contractors are not eligible for workers’ compensation in Pennsylvania. Employers must verify that individuals legally qualify as independent contractors before classifying them as such.
To assess whether you’re required to carry coverage, ask:
Am I an employer under Pennsylvania law?
Is my worker entitled to coverage or legally exempt?
Pennsylvania employees who suffer a work-related injury or illness are typically entitled to:
Wage replacement – Up to two-thirds of their wages, subject to a legal maximum
Medical care – Full reimbursement of reasonable healthcare costs (even if no time is lost from work)
Total disability benefits – For employees unable to return to work due to serious injury or illness
Partial disability benefits – For employees able to return to work in a limited capacity
Death benefits – For eligible surviving dependents
Specific loss awards – For permanent disabilities affecting certain body parts (e.g., hands, limbs, hearing, sight)
Employers in Pennsylvania can secure workers’ comp coverage through four primary options:
Licensed insurance agent or broker
Direct purchase from an approved private insurer (over 300 operate in PA)
Self-insurance, if eligible and approved by the BWC (requires financial stability and operational history of 3+ years)
State Workers’ Insurance Fund (SWIF) – For new or high-risk businesses struggling to obtain private coverage
For additional insurance information, consult the Pennsylvania Insurance Department’s consumer guide.
Failing to carry required coverage can result in severe penalties for Pennsylvania employers:
Reimbursement to the Uninsured Employers Guaranty Fund for all benefits paid, plus fees and interest
Misdemeanor charges – Up to $2,500 in fines and one year of imprisonment per day without coverage
Felony charges for intentional noncompliance – Up to $15,000 in fines and seven years of imprisonment per day
$200 per day fines for failure to respond to BWC coverage inquiries (up to 30 days)
Pennsylvania’s claims process requires both the employee and employer to act promptly:
Employee must report the injury within 21 days (no later than 120 days) to remain eligible
Employee may choose a medical provider from the employer’s designated list for the first 90 days
Employer must immediately notify the insurance carrier or program administrator
Employer must report the injury to the BWC within 48 hours (if fatal) or within seven days (if resulting in disability > one day)
Insurer must accept or deny the claim within 21 days of notification
If accepted, compensation agreements are issued. If denied, the employee has three years to appeal.
In cases involving uninsured employers, the SWIF fund will pay out benefits, but the employer must later reimburse all associated costs.
Having a workers’ comp policy helps protect both your team and your business. If an incident occurs, employees gain access to essential benefits, including wage replacement and medical care, while employers meet legal obligations and avoid penalties.
If you need help setting up a policy, Beyond is here to support your compliance and operations.
